A woman 55 yrs old lady complains of Post-Menopausal bleeding. Pelvic exam shows a normal cervix. Also, a pap smear done 1 month prior is normal. She has no other co morbidities USG reveals endometrial thickness of 1 mm , atrophic ovaries. Most probable diagnosis is?

Correct Answer: Senile endometritis
Description: Endometrial thickness is not increased, a ca endometrium is hence unlikely. Pelvic exam and paps smear are normal, so cervical cancer is unlikely. Senile endometritis appears to be the most probable cause as it is fairly common and the endometrium is atrophic (1 mm) A postmenopausal woman with vaginal bleeding should prompt indian clinicians to look out for ca cervix always. However, Ca cervix is ruled out in this case with the findings provided. In the western countries the most common cause of post menopausal bleeding is senile endometritis happening in an atrophic endometrium. Ovaries are atrophic so ovarian cancer is unlikely
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